Very little has been written about the emotional and psychological demands of being a paramedic, and there is even less about student paramedics' experiences of these aspects of professional practice.
Overall, this qualitative study aimed to explore student paramedics’ understanding and experiences of what is referred to as ‘emotion work’ within clinical practice, and to identify strategies used for managing emotional demands when working with patients.
As little is known about these phenomena it was entirely appropriate to adopt an exploratory, inductive approach to this study. Students from the second year of a pre-registration diploma programme in paramedic science were invited to participate. In total, six male and two female students were recruited. The paper indicates that these students had experienced four practice placements at the time of their recruitment, although no further information about the length or type of placements is provided.
Data were collected through semi-structured interviews which lasted between 30–45 minutes. The interviews were audio-recorded and transcribed.
Thematic content analysis facilitated identification of three broad themes: ‘getting on with the job’ ‘struggling with emotion’ and ‘talking it through’. Williams (2012) identifies that only the first two themes are discussed in this paper.
‘Getting on with the job’ was divided into three sub themes including: 1) ‘Control and suppression of emotion’ where participants identified a need to mask or suppress their emotions in order to focus on the job/situation; 2) ‘Got to deal with it’ with participants giving examples about other people’s expectations (both staff and patients) that they should be able to remain professional and in control no matter what situations they encounter; 3) ‘Don't see them as a person/ patient’ with participants describing being so engaged with a task or protocol that momentarily they forget that they are dealing with human beings, refecting a process of depersonalisation which may serve as a coping mechanism in traumatic situations.
The second main theme of ‘Struggling with emotion’ was further divided into 1) ‘Not sure what to say’ when participants found themselves trying to manage highly stressful situations where they were not sure what was going to happen and, therefore did not know what to say to patients or relatives; 2) ‘Personal links’ such as when a participant may liken a patient to a member of their own family; 3) ‘Stop myself crying’ with participants refecting on events where they had to control emotions to stop themselves from crying so as to maintain professional integrity.
Williams recognises limitations in her study such as the small sample size (not in itself a limitation for qualitative research), and the specific focus on one higher education institution. She identifies these findings are not intended to be generalizable, but suggests they have potential to be transferable.
To increase currency within the background and discussion sections, perhaps some consideration could have been given to the content of the Paramedic Curriculum Guidance and Competence Framework 2nd edition (College of Paramedics, 2008), rather than only referring to the Curriculum Framework for Ambulance Education (British Paramedic Association, 2006).
In summary, this is a unique, rigorous and valuable study generating rich information which provides an insight into some of the challenges faced by these student paramedics in relation to emotion work in the early part of their clinical careers.
Williams recommends that, within paramedic science curricula, more attention needs to be devoted to this area of clinical practice in order to ensure that students are well prepared and supported to effectively undertake emotion work in their current and future roles.